Organization · Type 2 NPI

Shelby Residential & Vocational Services, Inc.

Intellectual Disabilities Intermediate Care Facility · Memphis, TN

NPI number 1043467103 Active

Practice location

3250 Sandwick Rd
Memphis, TN 38128-4154

Call (901) 357-0994 Map

Fax (901) 312-9906

Mailing address

3971 Knight Arnold Rd
Memphis, TN 38118-3004

Specialties and licenses

Taxonomy	Code	License
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	L323-067-6620 (TN)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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NPI record

NPI: 1043467103
Entity type: Organization (Type 2)
Issued: Aug 20, 2008
Last updated: May 2, 2024
Status: Active
Subpart: Yes of Shelby Residential & Vocational Services, Inc.

Other names

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Sandwick · doing business as
Sandwick · doing business as

Authorized official

Shannon Durbin
Executive Director
(901) 312-6845

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043467103

Shelby Residential & Vocational Services, Inc.'s National Provider Identifier is 1043467103, issued on Aug 20, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Memphis, TN. The record was last updated on May 2, 2024.